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Dr. Jon Parmiter, DC offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form (Virginia Beach Sports Chiropractic Intake Form)

* It should be noted that all New Patient appointments that are canceled within two hours of the scheduled time are subject to a $25.00 fee.


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Sign up using the form below or call 757-557-0010 to make an appointment.

Office Hours

Day
Monday8:00-12:003:00-6:00
Tuesday9:00-12:00
Wednesday8:00-12:003:00-6:00
Thursday9:00-12:00
Friday8:00-12:003:00-6:00
SaturdayClosed
SundayClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00-12:00 9:00-12:00 8:00-12:00 9:00-12:00 8:00-12:00 Closed Closed
3:00-6:00 3:00-6:00 3:00-6:00